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Original Article · Originalarbeit

Transfus Med Hemother 2008;35:368–373 Received: March 25, 2008

Accepted: July 1, 2008
DOI: 10.1159/000151351 Published online: September 16, 2008

Comparison of Plateletpheresis on the Fenwal Amicus

and Fresenius Com.Tec Cell Separators
Fevzi Altuntasa Ismail Sarib Ismail Kocyigita Leylagul Kaynara Sibel Hacioglub
Ahmet Ozturkc Mehmet Oztekina Musa Solmaza Bulent Esera Mustafa Cetina Ali Unala
a Department of Hematology and Apheresis Unit, Erciyes Medical School, Kayseri
b Department of Hematology, Pamukkale Medical School, Denizli
c Department of Statistics, Erciyes Medical School, Kayseri, Turkey

Key Words Schlüsselwörter

Plateletpheresis · Apheresis · Amicus · COM.TEC · Thrombozytenapherese · Apherese · Amicus · COM.TEC ·
Cell separator Zellseparator

Summary Zusammenfassung
Background: A variety of apheresis devices are now available Hintergrund: Eine Reihe von Apheresevorrichtungen für die
on the market for plateletapheresis. We compared two aphere- Thrombozytenapherese ist mittlerweile auf dem Markt verfüg-
sis instruments (Fenwal Amicus and Fresenius COM.TEC) with bar. In der vorliegenden Arbeit werden zwei Apheresevorrich-
regard to processing time, platelet (PLT) yield and efficiency, tungen (Fenwal Amicus und Fresenius COM.TEC) hinsichtlich
and white blood cell (WBC) content. Material and Methods: der Parameter Separationszeit, Thrombozytengehalt und -effi-
Donors undergoing plateletpheresis were randomly separated zienz sowie Gehalt an weißen Blutzellen (WBC) verglichen.
into two groups (either the Amicus or the COM.TEC cell separa- Material and Methoden: Spender, bei denen eine Thrombo-
tor). Results: In the pre-apheresis setting, 32 plateletpheresis zytenapherese zum Einsatz kam, wurden randomisiert auf zwei
procedures performed with each instrument revealed no signif- Gruppen verteilt (entweder Amicus- oder COM.TEC-Zellsepa-
icant differences in donors’ sex, age, weight, height and total rator. Ergebnisse: In einem Vorapherese-Setting zeigten 32
blood volume between the two groups. However, the pre- Thrombozytenapheresevorgänge, die mit jedem Instrument
apheresis PLT count was higher with the COM.TEC than with durchgeführt wurden, keine signifikanten Unterschiede hin-
the Amicus (198 × 103/μl vs. 223 × 103/μl; p = 0.035). The blood sichtlich Geschlecht, Alter, Gewicht, Größe und Gesamtblutvo-
volume processed to reach a target PLT yield of ≥3.3 × 1011 lumen des Spenders zwischen den beiden Gruppen. Allerdings
was higher in the COM.TEC compared to the Amicus (3,481 vs. war der Präapherese-Thrombozytengehalt mit dem COM.TEC
2,850 ml; p < 0.001). The median separation time was also sig- höher als mit dem Amicus (198 × 103/μl vs. 223 × 103/μl; p =
nificantly longer in the COM.TEC than in the Amicus (61 vs. 0,035). Das prozessierte Blutvolumen, das zur Erreichung des
44 min; p < 0.001). 91 and 88% of the PLT products collected Ziel-Thrombozytengehalts von ≥ 3,3 × 1011 benötigt wurde, war
with the Amicus and the COM.TEC, respectively, had a PLT beim COM.TEC höher als beim Amicus (3481 vs. 2850 ml; p <
count of ≥3.3 × 1011 (p = 0.325). All products obtained with both 0,001). Die mediane Separationszeit war beim COM.TEC signifi-
instruments had WBC counts lower than 5 ↔ 106, as required. kant höher als beim Amicus (61 vs. 44 min; p < 0,001). 99 bzw.
There was no statistical difference with regard to collection effi- 88% der Thrombozytenprodukte, die mit dem Amicus bzw. mit
ciency between the devices (55 ± 15 vs. 57 ± 15%; p = 0.477). dem COM.TEC gesammelt wurden, hatten einen Thrombozy-
However, the collection rate was significantly higher with the tengehalt von ≥3,3 × 1011 (p = 0,325). Sämtliche mit beiden Ge-
Amicus compared to the COM.TEC instrument (0.077 ± 0.012 × räten gewonnenen Produkte wiesen die vorgeschriebene WBC-
1011 vs. 0.057 ± 0.008 × 1011 PLT/min; p < 0.001). Conclusion: Anzahl von <5 × 106 auf. In Bezug auf die Sammlungseffizienz
Both instruments collected platelets efficiently. Additionally, gab es keine Unterschiede zwischen den beiden Geräten (55 ±
consistent leukoreduction was obtained with both instruments; 15 vs. 57 ± 15%; p = 0,477). Allerdings war die Sammelrate beim
however, compared with the COM.TEC instrument, the Amicus Amicus signifikant höher als beim COM.TEC (0,077 ± 0,012 ×
reached the PLT target yield more quickly. 1011 vs. 0,057 ± 0,008 × 1011 PLT/min; p < 0,001). Schlussfolge-
rung: Beide Geräte eignen sich zur effizienten Sammlung von
Thrombozyten. Zusätzlich wird mit beiden Geräten eine deutli-
che Leukoreduktion erzielt. Allerdings lässt sich mit dem Ami-
cus der Ziel-Thrombozytengehalt schneller erreichen als mit
dem COM.TEC.

© 2008 S. Karger GmbH, Freiburg Fevzi Altuntas, MD

Department of Hematology and Apheresis Unit
Fax +49 761 4 52 07 14 Accessible online at: Erciyes Medical School 38039 Kayseri, Turkey Tel. +90-532 6588050, Fax -352 4379348
368_373_03001_altuntas:368_373_03001_altuntas 30.09.2008 11:42 Uhr Seite 369

Introduction Instruments

A single Fenwal Amicus instrument with software version 2.52 (Baxter

There are many advantages to donor plateletpheresis. Among
Healthcare, Deerfield, IL, USA) was used. A double venous access with
these are the following: economic use of blood due to selective a plateletpheresis kit was used per the manufacturer’s recommendation.
collection of a relatively large amount of components, possi- The parameters of the Amicus device were as follows: whole blood flow
bility of more frequent donations, elimination of unnecessary 55–80 ml/min, interface set point 0.60, and anticoagulant/whole blood ratio
component separation in the laboratory, reduced donor expo- 1:8–11. The second cell separator used for PLT collection was the blood
cell separator COM.TEC, software version 4.0 (Fresenius HemoCare
sures and therefore reduced risk of disease transmission and
GmbH, Bad Homburg, Germany). Per the manufacturer’s recommenda-
risk of human leukocyte antigen (HLA) alloimmunization, use tions, we used a double venous access with a C5L kit in a dual-needle pro-
as an effective treatment for already alloimmunized patients, cedure (program PLT5d DN). The machine parameters were as follows:
and labeling as ‘leukoreduced’ without further manipulation whole blood flow 50–75 ml/min, interface set point 33, and anticoagu-
[1–5]. Although improvements in apheresis technology are on- lant/whole blood ratio 1:8–12. The following data were entered into the
cell separator program for both instruments: donors’ height, weight, sex,
going, some problems do remain, e.g. the duration of the pro-
hematocrit (Htc) and pre-apheresis PB platelet count. The processed
cedure and donor discomfort owing to the citrate used for an- blood volume to reach the target PLT yield (≥3.3 × 1011) was determined
ticoagulation. Minimization of these variables is the driving by both instruments. No additional post-procedure processing or filtration
motivation behind new apheresis instrument development. to obtain leukoreduced products was performed on either instrument.
Presently, there are a variety of plateletpheresis instruments
available on the market, and several studies focusing on the
Peripheral Blood Variables
comparison of different plateletpheresis cell separators have
been conducted [6–13]. There is, however, no published data Peripheral blood samples (2 ml, ethylene diamine tetraacetate (EDTA))
comparing the Fenwal Amicus and the Fresenius COM.TEC were drawn from each donor prior to and 2 h after completion of aphere-
cell separators. sis. Pre- and post-apheresis complete blood count (CBC) analysis was per-
formed. Donor PLT loss was analyzed using the following formula: PLT
In the present study, we compared plateletpheresis on the loss = (pre-PLT count – post-PLT count) × 100/pre-PLT count.
Fenwal Amicus cell separator (Baxter Healthcare, Deerfield,
IL, USA) and the COM.TEC cell separator (Fresenius Hemo-
Care GmbH, Bad Homburg, Germany) with respect to sepa- Operational Variables
ration parameters and platelet (PLT) yield characteristics such
We recorded all procedure times, the processed blood volume to reach
as processing times, PLT yields, separation efficiencies, and the PLT target yield, the flow rate, and the acid citrate dextrose-A (ACD-
white blood cell (WBC) content. A) volume used.

Platelet Yield Variables

Materials and Methods
After the PLT container had rested for 1 h without agitation, we obtained
The study included all healthy volunteer donors between January 2006 plateletpheresis yield samples with EDTA (2 ml) from the PLT bag for
and December 2006 who met the Council of Europe Guidelines and Rec- laboratory analysis. The yield was analyzed for volume, the numbers of
ommendations for apheresis and the standard guidelines established by WBC, red blood cells (RBC), and PLT, and swirling. Collection efficiency
the American Association of Blood Banks [14, 15]. Criteria for eligibility (CE) was calculated by the following formulas:
for a single unit (≥3.3 × 1011) were as follows: 1) age 18–60 years, 2) pre-
apheresis peripheral blood (PB) PLT count ≥ 150 × 109/l, 3) hemoglobin CE = total PLT yield (1011) × 100/(pre-apheresis PLT count + post-
(Hb) level ≥ 13.5 g/dl, 4) donor body weight ≥ 50 kg, 5) negative tests for apheresis PLT count/2) × blood volume processed (1).
HIV, hepatitis B surface antigen, hepatitis C, and syphilis, 6) absence of Blood volume processed = TBV processed – ACD-A (ml) (2).
any illness, 7) in good health and feeling well, 8) adequate venous access-
es, 9) at least 3 months since last whole blood donation, 10) at least 3 days Collection rate (CR) was calculated by the formula:
since last plateletpheresis, and 11) no consumption of non-steroidal anti- CR = PLT yield/separation time (3).
inflammatory drugs and acetyl salicylic acid in the last 7 days [16].
The study was approved by the Institutional Review Board. Written con- The ratio of PLT yield/blood volume processed was also calculated.
sent was obtained after procedural risks were explained in detail before Complete blood counts were determined using an automated blood cell
the procedure. Plateletpheresis donors were sequentially assigned to ei- counter (Sysmex XT 2000i, Roche diagnostics, Sysmex Corporation, Kobe,
ther the Baxter Amicus cell separator or the Fresenius COM.TEC device. Japan), swirling was observed against light, and residual leukocyte con-
Antecubital veins were used for the venipuncture in all the donors. Senior centrations in the PLT concentrate were determined by flow cytometry on
apheresis technicians performed all procedures. Vital signs were moni- a FACS Calibur (Becton Dickinson, Franklin Lakes, NJ, USA) in platelet-
tored at the beginning and end of each procedure; donors were also mon- pheresis yields.
itored for adverse events during the apheresis procedures. Pre-procedure
donors’ height, weight, sex, and total blood volume (TBV) were also
recorded. None of the donors received routine prophylactic oral or intra- Statistics
venous calcium during the apheresis procedure.
Data were expressed as the median (range) and mean ± standard devia-
tion (SD). The Amicus and the COM.TEC instruments were compared

Comparison of Plateletpheresis on the Transfus Med Hemother 2008;35:368–373 369

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Table 1. Donors’ characteristics Plateletpheresis Operational Variables

Amicus COM.TEC p
The median blood volume processed to reach a PLT yield
(n = 32) (n = 32) value
≥ 3.3 × 1011 was significantly higher with the COM.TEC com-
Male/female 29/3 30/2 0.644 pared to the Amicus (3,481 vs. 2,850 ml; p < 0.001). Addition-
Age, years; median (range) 28 (18–43) 29 (21–49) 0.146 ally, the median flow rate of the Amicus was significantly high-
Weight, kg; mean ± SD 73.9 ± 10.4 74.1 ± 7.1 0.946 er than the median flow rate of the COM.TEC (65 vs.
Height, cm; median (range) 170 (155–185) 170 (163–180) 0.839
58 ml/min; p < 0.001). Furthermore, there was a significantly
TBV, ml; mean ± SD 5,142 ± 778 5,197 ± 464 0.696
TBV = Total blood volume. higher median volume of ACD used in collections on the
COM.TEC (373 vs. 300 ml; p < 0.001). However, the mean cit-
rate load per minute was higher in the Amicus compared to
the COM.TEC (6.6 ± 0.8 vs. 6.1 ± 0.5 ml/min) (p = 0.042). The
using an unpaired t-test or the Mann Whitney U test with regard to pre-
median time needed for the procedures was also significantly
and post-apheresis peripheral blood variables, plateletpheresis opera- longer with the COM.TEC (61 vs. 44 min; p < 0.001). The
tional variables and product variables. An unpaired t-test was used for pe- plateletpheresis procedure data are shown table 3.
ripheral blood variables (e.g. pre-apheresis Hb, pre-apheresis Htc level,
post-apheresis Hb level and post-apheresis Htc level, TBV, body weight of
donor) and plateletpheresis product variables (e.g. collection rate), which
were within normal distribution. The Mann Whitney U test was used for
Plateletpheresis Product Variables
peripheral blood variables (e.g. pre-apheresis WBC count, pre-apheresis
PLT count, post-apheresis PLT count, post-apheresis WBC count and Hb The plateletpheresis product variables are summarized in
loss% and PLT loss%), plateletpheresis operational variables (e.g. blood table 4. There were no significant differences in terms of
volume processed, flow rate, product volume and separation time) and
swirling percent, PLT yield/bag, and WBC count/bag (table 4).
plateletpheresis product variables (e.g. pH, WBC count/bag and PLT
count/bag), which were not within normal distribution. Data were ana-
However, PLT yield/blood volume processed was significantly
lyzed on the SPSS software platform (SPSS 13.0, Chicago, IL, USA). The higher with the Amicus (0.42 vs. 0.33; p < 0.001). The percent-
level of significance was set at p < 0.05. age of PLT yield ≥ 3.3 × 1011/bag was 91% (29/32) and 88%
(28/32) on the Amicus and the COM.TEC instrument, respec-
tively (p = 0.325). A CE of 55 ± 15% was obtained on the Am-
Results icus and 57 ± 15% on the COM.TEC (p = 0.477). However,
the CR was statistically higher with the Amicus (0.077 ± 0.012
The general characteristics of in total 64 donors (n = 32 in the × 1011 vs. 0.057 ± 0.008 × 1011 PLT/min; p < 0.001). All products
Amicus group and n = 32 in the COM.TEC group) are given obtained with both instruments had WBC counts lower than
in table 1. The median age of the donors was 28 (range, 18–43 5 × 106, as required. Additionally, the number of products with
years) and 29 years (range, 21–49 years) for the Amicus group <1 × 106 WBC was 30 (94%) with the Amicus and 28 (87%)
and the COM.TEC group, respectively. While there were 29 with the COM.TEC (p = 0.325).
males and 3 females in the Amicus group, there were 30 males
and 2 females in the COM.TEC group. There was also no sta-
tistically significant difference between the two groups in Adverse Effects of Plateletpheresis
terms of weight, height, and TBV of the donors.
There were no high-rate adverse events that would cause early
termination of the procedure. However, citrate-related mild
Pre- and Post-Apheresis Peripheral Blood Variables toxicity occurred more commonly on the COM.TEC (6
donors) than on the Amicus (4 donors), due probably to the
Pre- and post-apheresis PB data are shown in table 2. There larger amounts of ACD-A used (300 vs. 373 ml; p < 0.001). All
were no significant differences in pre-apheresis Hb levels, Htc reactions responded rapidly to decreased flow rates and/or
levels, and WBC counts. However, the pre-apheresis PLT oral calcium supplementation.
count was significantly higher in patients on the COM.TEC
instrument compared to the Amicus (198 × 103/μl vs. 223 ×
103/μl; p = 0.035); no statistical differences in post-apheresis Discussion
PB Hb and Htc levels were noted between the instruments.
The post-apheresis PLT count was significantly lower in the Although a variety of apheresis devices are currently available
Amicus compared to the COM.TEC group (144 × 103/μl vs. on the market for plateletpheresis procedures, there are scant
164 × 103/μl; p = 0.019); there were, however, no statistically data concerning plateletpheresis with the COM.TEC machine
significant differences between the percentages of PLT and [13, 17, 18]. Additionally, there is no published data comparing
Hb loss (table 2). the COM.TEC and the Amicus instruments used for platelet-

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Table 2. Pre-and post-apheresis donor CBC

Amicus COM.TEC p value

Pre-apheresis WBC (× 103/μl); median (range) 6.95 (4.4–11.2) 7.55 (5.1–10.4) 0.07
Post-apheresis WBC (× 103/μl); median (range) 6.6 (3.9–9.7) 6.5 (4.0–10.0) 0.746
WBC loss, %; median (range) 11.5 (0–36.2) 16 (0–25) 0.05
Pre-apheresis Hb level, g/dl; mean ± SD 15.6 ± 1.4 15.4 ± 1.3 0.540
Post-apheresis Hb level, g/dl; mean ± SD 14.6 ± 1.5 14.5 ± 1.5 0.882
Hb loss ,%; median (range) 6.5 (0–9.3) 6.3 (3.3–13.6) 0.605
Pre-apheresis Htc level, % 44.5 ± 2.7 43.5 ± 3.2 0.259
Post-apheresis Htc level, % 41.4 ± 3.1 41.7 ± 4.2 0.979
Htc loss, %; median (range) 5.5 (2.2–18.4) 5.9 (0–9.9) 0.171
Pre-apheresis PLT count (× 103/μl); median (range) 198 (159–313) 223 (180–248) 0.035*
Post-apheresis PLT count (× 103/μl); median (range) 144 (105–206) 164 (109–237) 0.019*
PLT loss, %; median (range) 32 (19–40) 29 (3–39) 0.07

WBC = White blood cell; Hb = hemoglobin; Htc = hematocrit; PLT = platelet.

*p = Statistically significant.

Table 3. Plateletpheresis kinetics and

procedural data Amicus COM.TEC p value

Blood volume processed, ml; median (range) 2,850 (2,500–3,500) 3,481 (2,742–4,139) <0.001
Flow rate, ml/min; median (range) 65 (55–75) 58 (50–65) <0.001
ACD-A volume, ml; median (range) 300 (210–341) 373 (294–407) <0.001
Separation time, min; median (range) 44 (37–58) 61 (48–72) <0.001
Product volume, ml; median (range) 285 (260–340) 300 (300–304) <0.001

Table 4. Plateletpheresis product data

Amicus COM.TEC p value

Swirling percent 100 100

PLT yield/bag (× 1011); median (range) 3.39 (2.84–4.03) 3.33 (2.87–3.94) 0.185
Number of PLT yield ≥ 3.3 × 1011/bag 29/32 (91%) 28/32 (88%) 0.325
PLT yield/blood volume processed 0.42 0.33 <0.001*
WBC count/bag (× 106); median (range) 0.30 (0.30–1.20) 0.57 (0.26–1.43) 0.805
Number of yield with WBC < 1 × 106 30 (94%) 28 (87%) 0.399
RBC count/bag (× 106); mean ± SD 4.3 ± 10.2 13.18 ± 15.18 0.008*
Collection efficiency, %; mean ± SD 55 ± 15 57 ± 15 0.477
Collection rate (PLT 1011/min); mean ± SD 0.077 ± 0.012 0.057 ± 0.008 <0.001*

PLT = platelet, WBC = white blood cell.

*p = Statistically significant.

pheresis. This study documents the features of the COM.TEC PLT yield of these products was 3.11 ± 0.40 × 1011. Strasser et
and compares it to the widely used Amicus instrument with al. [13] reported a processed blood volume of 2.49 ± 0.50 l and
respect to parameters such as separation time, PLT yield, CE, a mean separation time of 54 ± 13 min for a mean PLT yield of
and WBC content. In today’s world, productivity, i.e. ‘doing 2.90 ± 0.54 × 1011 PLT using the COM.TEC. Burgstaler et al.
more in less time’, is as key a feature as yield when evaluating [9] recorded median separation times of 77 min for a median
equipment. Coffe et al. [17] recorded the French experience PLT yield of 5.03 × 1011 with the Amicus. Additionally, Ben-
on plateletpheresis with the COM.TEC cell separator; the jamin et al. [10] reported average separation times of 71.5 min
blood volume processed was 4,606–5,229 l, and the mean sepa- for median yields of 4.9 × 1011 PLT using the Amicus. In this
ration time was between 87–109 min to reach a target PLT study, the median blood volume processed to reach a target
yield of 4.74 × 1011 to 5.95 × 1011 with the COM.TEC machine. PLT yield of 3.3 × 1011 was significantly higher with the
Moog et al. [18] reported an average processed blood volume COM.TEC (3,481 vs. 2,850 ml; p < 0.001). For this reason,
of 2,826 ± 409 ml in a donation time of 55 ± 11 min; the mean there was a significantly longer mean separation time with the

Comparison of Plateletpheresis on the Transfus Med Hemother 2008;35:368–373 371

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COM.TEC (61 vs. 44 min; p < 0.001). On the other hand, they (p = 0.477). Compared to results reported in the literature, our
do report that sex, age, weight, TBV and pre-procedure PLT COM.TEC CE results (57 ± 15%) were similar to those re-
count affect PLT yield [13, 18]. In the present study, no signifi- ported: 52–55% [13, 17, 18]. However, our Amicus results
cant differences were noted with regard to sex, age, weight, (55 ± 15%) were lower than the reported averages of 66–73%
height and TBV between the two instruments; however, the [8–11, 19–22]. On the other hand, when comparing the instru-
median pre-procedure PLT counts were significantly different ments with regard to PLT yield/blood volume processed, the
(198 × 103/l vs. 223 × 103/l; p = 0.035). This difference in the Amicus showed a significantly higher ratio compared to the
pre-apheresis PLT counts between the two groups may be due COM.TEC (0.42 vs. 0.33; p < 0.001). Moreover, while the CR
to insufficient numbers of donors per study arm as well as to was statistically higher with the Amicus (0.077 ± 0.012 vs. 0.057
performing in different subsequent time periods. Additionally, ± 0.008; p < 0.001), the CR of both machines was comparable
there was no statistically significant difference with respect to to that reported in the literature [8, 9, 20, 23].
the median PLT yield of products per component between the Efficient platelet collection with fewer procedure-related side
separators (3.39 × 1011 vs. 3.33 × 1011; p = 0.185). effects is an important consideration for donors. The most
One important advantage of plateletpheresis is that no further common procedural adverse effects are citrate related [16–18,
manipulation is required for the product to be labeled as 24]; the incidence of citrate toxicity varies from 0.11 to 16% in
‘leukoreduced’. Leukocytes must be <5 × 106 per concentrate different studies [8, 25–28]. Citrate-related reactions have
according to USA standards and <1 × 106 per concentrate ac- been observed in 0.5% of cases on the COM.TEC machine
cording to European standards [14, 15]. Coffe et al. [17] re- [17]. Additionally, Benjamin et al. [10] reported that mild cit-
ported that the residual leukocyte levels were <1 × 106 per rate-related toxicity occurred more commonly on the Amicus
concentrate (mean 0.233 ± 0.150 × 106) in more than 97% of than on the Spectra LRS separator, as a result of the larger
the components produced (confidence interval (CI) of >95%). amount of ACD used (483 vs. 389 ml; p < 0.0001). However,
Moog et al. [18] recorded mean WBC contaminations of 0.11 these adverse reactions were successfully treated by reducing
± 0.20 × 106 with the COM.TEC. Strasser et al. [13] reported the ACD infusion rate, the amount of ACD used and/or oral
that nearly all of the PLT products collected with the calcium supplementation [13, 17, 18]. In the present study,
COM.TEC, the AS.TEC204, and the COBE spectra met the since there were significant differences between the flow rates
AABB standards as well as the more stringent European of the devices, separation time and ACD consumption were
guidelines. Using the Amicus, Laurencet et al. [20] reported also found to be statistically significant (p < 0.001). Addition-
<5 × 106 WBC in 98% of the products and <1 × 106 WBC in ally, there were statistically significant differences between the
84%. Additionally, some studies have confirmed the consis- two groups in terms of the citrate load per minute (p = 0.042).
tency of leukoreduction [9–11, 21]. In the present study, all The higher ACD consumption but lower citrate load per
products obtained with both instruments had a WBC content minute of the COM.TEC procedure may be explained with
<5 × 106 (0.30 × 106 to 1.2 × 106 vs. 0.26 × 106 to 1.43 × 106; p = the low number of donors per arm. Citrate-related mild toxic-
0.805). Additionally, the number of products with <1 × 106 ity occurred more commonly on the COM.TEC (6 donors)
WBC was 30 (94%) with the Amicus and 28 (87%) with the than on the Amicus (4 donors). However, this was not clinical-
COM.TEC instrument (p = 0.325). ly significant.
Efficient PLT collection is an important issue when comparing In conclusion, both instruments perform plateletpheresis effi-
instruments; the new generation of instruments appears to be ciently. Additionally, consistent leukoreduction was obtained
more efficient [9]. In the present study, we noted a CE of 55 ± with both machines. The Amicus, however, has the advantage
15% with the Amicus and of 57 ± 15% with the COM.TEC of a lower separation time.

1 Price TH: Provision of single-donor platelet trans- 5 Schreiber GB, Busch MP, Kleinman SH, Korelitz JJ: 9 Burgstaler EA, Pineda AA, Bryant SC: Prospective
fusions: Patient and producer perspectives; in The risk of transfusion-transmitted viral infections. comparison of plateletapheresis using four aphere-
McLeod BC, Price TH, Weinstein R (eds): Aphere- The Retrovirus Epidemiology Donor Study. N Engl sis systems on the same donors. J Clin Apher 1999;
sis: Principals and Practice. Bethesda, AABB Press, J Med 1996;334:1685–1690. 14:163–170.
2003, pp 185–197. 6 Burgstaler EA, Pineda AA, Brecher MA: Plateleta- 10 Benjamin RJ, Rojas P, Christmas S, Neal J,
2 Vassallo R, Murphy S: Platelet functions, kinetics pheresis: comparison of platelet yields, processing Broughton S, Burgio C, Barrett B, Churchill WH:
and metabolism: Impact on quality assessment, time, and white blood cell content with two aphere- Plateletapheresis efficiency: a comparison of the
storage and clinical use; in McLeod BC, Price TH, sis systems. Transfusion 1993;33:393–398. Spectra LRS and Amicus seperators. Transfusion
Weinstein R (eds): Apheresis: Principals and Prac- 7 Beyan C, Cetin T, Kaptan K, Nevruz O: Effect of 1999;39:895–899.
tice. Bethesda, AABB Press, 2003, pp 161–183. plateletpheresis on complete blood count values 11 Moog R, Muller N, Goergens D: Platelet collection
3 Ness P, Braine H, King K, Barrasso C, Kickler T, using three different cell separator systems in with the Amicus and AS.TEC 204 blood cell sepa-
Fuller A, Blades N: Single-donor platelets reduce healthy donors. Transfus Apher Sci 2003;29:45–47. rators. Transfusion 1998;38:285–289.
the risk of septic platelet transfusion reactions. 8 Burgstaler EA, Pineda AA, Wollan P: Plateleta- 12 Ranganathan S: Comparison of plateletapheresis
Transfusion 2001;41:857–861. pheresis: Comparison of processing times, platelet on the Fresenius AS.TEC 204 and Haemonetics
4 Slichter SJ: Platelet refractoriness and alloimmu- yields, and white blood cell content with several MCS 3p. J Clin Apher 2007;22:1–4.
nization. Leukemia 1998;12:51–53. commonly used systems. J Clin Apher 1997;12:

372 Transfus Med Hemother 2008;35:368–373 Altuntas/Sari/Kocyigit/Kaynar/Hacioglu/

368_373_03001_altuntas:368_373_03001_altuntas 30.09.2008 11:42 Uhr Seite 373

13 Strasser EF, Schuster M, Egler K, Bauer J, Weis- 18 Moog R, Zeiler T, Heuft HG, Stephan B, Fischer 23 Moog R, Muller N: Evaluation of the single needle
bach V, Ringwald J, Zimmermann J, Zingsem J, EG, Kretschmer V, Rödel-Spieker R, Strasser E, procedure in plateletapheresis with Fresenius
Eckstein R: Frequently used plateletpheresis tech- Zingsem J: Collection of WBC-reduced single- AS104 blood cell separator. J Clin Apher 1995;10:
niques result in variable target yields and platelet donor PLT concentrates with a new blood cell sepa- 90–95.
recruitment of donors. Transfusion 2005;45: rator: results of a multicenter study. Transfusion 24 McLeod BC, Price TH, Owen H, Ciavarella D,
788–797. 2003;43:1107–1114. Sniecinski I, Randels MJ, Smith JW: Frequency of
14 Council of Europe Guide to the preparation, use 19 Kalish RI, Chambers LA, Linden JV: The effect of immediate adverse effects associated with aphere-
and quality assurance of blood components, ed 10. plateletapheresis on the Fenwal CS3000 on donor sis donation. Transfusion 1998;38:938–943.
Strasbourg, Council of Europe Press, 2004. platelet counts. J Clin Apher 1987;3:230–234. 25 Bueno JL, Barea L, Garcia F, Castro E: A compari-
15 Fridey JL (ed): Standards for blood banks and 20 Laurencet FM, Doucet A, Lydiate V, Jacquier MC, son of PLT collections from two apheresis devices.
transfusion services, ed 22. Bethesda, American As- Mermillod B, Andersen S, Chapuis B: Quality eval- Transfusion 2004;44:119–124.
sociation of Blood Banks, 2003. uation of plateletapheresis using the new Amicus 26 Despotis GJ, Goodnough LT, Baorto D, Spitznagel
16 Randels MJ: Selection and care of apheresis (Baxter) cell separator: evolution of CD62 expres- E: Adverse events in platelet apheresis donors: a
donors; in McLeod BC, Price TH, Weinstein R sion. J Clin Apher 1998;13:47–55. multivariate analysis in a hospital based pro-
(eds): Apheresis: Principals and Practice. Bethesda, 21 Yockey C, Murphy S, Eggers L, Garratty G, Dingle gramme. Vox Sang 1999;77:24–32.
AABB Press, 2003, pp 131–142. A, Helms C, Moroff G: Evaluation of the Amicus 27 Makar YF, Butler MO, Cockersole GM, Gabra G,
17 Coffe C, Benguella M, Domy M, Cottier D, Guig- separator in the collection of apheresis platelets. Serevitch JM: National audit of citrate toxicity
nier F, N’gondara JP, Carrere A, Masse M, Naege- Transfusion 1998;38:848–854. in plateletpheresis donors. Transfus Med 2002;12:
len C, Biggio B, Tiberghien P, Herve P, Bouzgarrou 22 Schooneman F: Deleukocytation of plateletphere- 187–191.
R, Maurel JP, Vezon G, Vidal M, Quainon F, Bena- sis concentrates obtained with the use of Amicus 28 Strauss RG: Safety of donating multiple products
mara A, Lamy B, Beaumont JL, Bierling P, cell separators. Transfus Apher Sci 2001;25:61–62. in a single apheresis collection: are we expecting
Gondrexon G, Schooneman F, Janot C, Villard F, too much? J Clin Apher 2003;18:135–140.
Huart JJ: Plateletpheresis concentrates produced
with the COMTEC cell separator: the French expe-
rience. Transfus Apher Sci 2001;25:67–72.

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Fenwal Amicus and Fresenius Com.Tec Cell

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